The Impact of Sandplay Therapy on Perceptual Reasoning and Neuropsychological Functioning in Children with Autism: A Randomized Controlled Trial

Abstract

This study aimed to evaluate the effectiveness of Sandplay Therapy on enhancing perceptual reasoning and neuropsychological functioning in children with Autism Spectrum Disorder (ASD). A randomized controlled trial design was used, involving 30 children aged 6-12 years diagnosed with ASD. Participants were randomly assigned to either the intervention group (n=15) or the control group (n=15). The intervention group received eight 90-minute sessions of Sandplay Therapy over two months, while the control group received standard care. The Wechsler Intelligence Scale for Children (WISC-V) and NEPSY-II were used to measure perceptual reasoning and neuropsychological functioning, respectively, at baseline, post-intervention, and five-month follow-up. Data were analyzed using mixed-design ANOVA with repeated measurements and Bonferroni post-hoc tests in SPSS-27. Descriptive statistics showed significant improvements in the intervention group for both perceptual reasoning (M=95.53, SD=7.48 at baseline to M=107.45, SD=8.21 post-intervention) and neuropsychological functioning (M=89.74, SD=6.95 at baseline to M=101.29, SD=7.56 post-intervention). Mixed-design ANOVA revealed significant main effects of time (F(2, 56)=30.15, p<.001, η²=0.52 for perceptual reasoning; F(2, 56)=32.75, p<.001, η²=0.54 for neuropsychological functioning) and group-by-time interactions (F(2, 56)=24.12, p<.001, η²=0.47 for perceptual reasoning; F(2, 56)=28.75, p<.001, η²=0.50 for neuropsychological functioning). Bonferroni post-hoc tests confirmed significant differences between baseline and post-intervention (p<.001) and baseline and follow-up (p<.001) for the intervention group. Sandplay Therapy significantly enhances perceptual reasoning and neuropsychological functioning in children with ASD. These improvements were sustained at follow-up, suggesting that Sandplay Therapy is an effective and sustainable intervention for this population.